MGMA 2009: Facing down the reform question mark


This year at MGMA, practice managers and physicians are coming together at a very tense time--a time when, in theory, Congress may be fixing to stand the industry on its head.

Medical groups are already feeling battered to begin with. After all, U.S. practices logged a dismal 2008, turning out less revenue than the previous year for the first time in ages--and 2009 may not turn out to be much better, if MGMA stats are any indication. Practice overhead continues to climb, staff support isn't getting any cheaper, and if insurance companies plan to do any administrative simplification, at best they're moving at a snail's pace.

Then, bear in mind that the industry is on the brink of health reform, which could potentially make things worse without solving physicians' current problems. While reform legislation could create a new class of insured patients who can pay their bills, there's lots of possible threats in the air as well, including:

* Patients could end up being insured, but by companies that pay as badly as Medicare (or worse), which won't help practices much.

* Patients could end up shirking the mandated insurance requirement, particularly if there's a big exemption from penalties, which doesn't do much for doctors' bottom line either.

* Health reform could take away Medicare reimbursement from doctors without supplying enough well-paying patients to make up the difference.

* Reform could take a new stick to doctors--such as a greater emphasis on pay-for-performance in Medicare--without a big enough carrot involved.

Consider the above possibilities, add other reimbursement and regulatory nightmares, stir with a swizzle stick, and you've got a cocktail nobody wants. 

That being said, this is probably the perfect time to attend a high-impact professional event, especially in a modern, airy, not-too-crowded city like Denver. Periods like this, when everything is up in the air, are a great time to clear your mind, catch a few minutes with your smartest colleagues and get a perspective on your plans.

If I were a vendor, I wouldn't expect this to be one of my better sales events, especially given the big dropoff practices have seen in patient volume. (EMR vendors could be an exception, of course!) But the MGMA membership, which has always seemed like a particularly cohesive and friendly group for its size, is likely to do plenty of good bonding and sharing at the show.

More importantly, people will have a chance to share on topics that are still on the bleeding edge, such as "medical home" practices and accountable care organization models. It's one thing to read about them in a publication like this one, but nothing beats the voice of experience.

OK, I guess I convinced myself, and hopefully you as well, that there's plenty we can accomplish at the upcoming show. Yes, things may be a bit scary right now, but as always, the industry will soldier through. And if a revolution comes, we'll deal with that then. For now, at least for a few precious days, it's time to relax and learn. - Anne

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